Remote Care Manager: Health Coordination & Utilization

MetroPlusHealth; New York (NY); Remote; USD 90.000 - 120.000; Vollzeit

Zusammenfassung

MetroPlusHealth in New York seeks a Care Manager to coordinate care across inpatient and outpatient settings, aiming to achieve high-quality patient outcomes while minimizing unnecessary expenses.

You will collaborate with PCPs and providers to direct care to the most appropriate setting, evaluate outcomes, and support members through outreach. The role requires a NYS license as RN, LPN, or PT and 2–5 years of clinical experience in an acute or applicable care setting.

Qualifikationen

• New York State license as Registered Nurse, Licensed Practical Nurse, or Physical Therapist.
• High School Diploma or GED required.
• 2–5 years of clinical experience in an acute or applicable care setting.
• UM/UR experience in managed care or hospital setting required.

Aufgaben

• Performs care management including admission certification, continued stay review, discharge planning, and services review.
• Oversee coordination and delivery of quality healthcare for all members in a cost-effective manner.
• Obtain clinical information from members’ PCP and providers; approve care meeting criteria; refer others to Medical Director.
• Identify utilization trends and member needs through reports and health assessment forms.
• Ensure utilization management activities comply with regulatory requirements.

Kenntnisse

Integrity and Trust

Customer Focus

Communication skills

Analytical skills

Jobbeschreibung

MetroPlusHealth in New York seeks a Care Manager to coordinate care across inpatient and outpatient settings, aiming to achieve high-quality patient outcomes while minimizing unnecessary expenses.

You will collaborate with PCPs and providers to direct care to the most appropriate setting, evaluate outcomes, and support members through outreach. The role requires a NYS license as RN, LPN, or PT and 2–5 years of clinical experience in an acute or applicable care setting.